Healthcare professionals have many tools in their arsenal to support diagnosis, but there are few things more important than taking a thorough and accurate history from the patient. Two of the articles in this month’s issue of Guidelines in Practice make reference to the same aphorism: ‘A careful history will lead to the diagnosis 80% of the time.’ The articles are on completely different topics (joint pain and urinary incontinence), which demonstrates that this maxim is applicable across the medical landscape.

Osteoporosis is often asymptomatic and can remain undiagnosed until a fragility fracture happens. Clinical history can be helpful for recognising those at risk of fragility fracture by identifying common risk factors. Dr David Stephens summarises new recommendations from the updated Scottish Intercollegiate Guidelines Network (SIGN) guideline on the management of osteoporosis and the prevention of fragility fractures. The article includes a table from the SIGN guideline, which details non‑modifiable and modifiable risk factors and co-existing diseases that are associated with fragility fracture and should prompt consideration of fracture-risk assessment.

In this month’s View from the ground article Dr Emma Nash writes about the impact of the COVID-19 pandemic on patients’ mental health, highlighting the important, but sometimes subtle, distinction between distress and mental illness: ‘Most of the patients who are struggling due to COVID-19 have a normal reaction, not psychopathology. This is not to say that as doctors we don’t have a role. Recognising normality has always been a key component of general practice, and articulating this, with active listening and a healthy dose of empathy, can go a long way.

I’ll finish with a bit of MGP news. It probably won’t come as a surprise that we have decided to run Guidelines Live as a virtual event, rather than holding a face-to-face event at Olympia London. This means that there will be no interruption to your guidance‑focused learning, and you will be able to experience the virtual conference without leaving the comfort of your home or workplace! The state-of-the-art virtual event platform is built to mirror the live event and give an immersive feeling, similar to what you would experience by attending in person. You will be able to watch sessions, visit exhibition booths, network with colleagues, and interact with exhibitors and speakers. The agenda is included in this issue—don’t forget to book your place at: